The high rate of pressure injuries is an urgent problem that causes real pain and suffering for too many people each year, and it only threatens to get worse as the population ages and becomes less mobile.
But in the mad rush to find new ways to treat or prevent the affliction, it's easy to lose track of what's really important - the specific needs and goals of each patient.
According to Karen Ousey, professor of skin integrity at the University of Huddersfield, the focus on the patients' perspective can often get muddled in the scramble to find innovative solutions to the stubborn, pervasive problem.
Prof. Ousey states that while UK policy demands that patients are involved in all medical decisions, the reality is not always so cut and dried. Many tests are administered without proper communication with the patient. Too often, she says, patients are not told what is being tested or given any instructions on what they need to do.
She also warns that this situation needs to change, particularly in the UK, because the number of people who are high risk for pressure injuries is climbing and will only continue to rise. From 2014 to 2024, the general number of people over the age of 65 in Britain is expected to grow five times faster than those under that age. The number of people in the UK over the age of 85 is also expected to reach new heights.
Ensuring that patients are more involved in medical decisions could help provide better care while cutting costs, which, she says, have quadrupled in the last six years. When choosing where to allocate funds for clinical trials, addressing the direct needs of patients should be at the heart of research projects.
Crucial Communication Between Patients and Caregivers
According to Prof. Ousey, good wound care – from research to practice – starts with the patient’s goal, not the doctor’s or nurse’s.
Improving the current situation requires three steps:
1. Gaining a deep understanding of patients’ wants and needs
Every patient wants a higher quality of life, but what that means will vary widely from patient to patient. For some, it might mean spending less time lying in bed. For others, it comes down to being able to sit through a theater performance.
For another group of patients, quality of life is about their mobility. Just being able to get into a taxi and go where they want to go means the world to them.
Researchers and caregivers must spend time listening to what patience say they want to achieve with their care. Internalizing this information will set the direction of research to outcomes that meet the goals and needs of the patients, and ultimately improve their quality of life – they way they see it.
2. Knowing what will work for them
Patients want to know that their preference will be considered, especially when a dilemma arises.
Some patients prefer treatment that will eliminate their wounds as quickly as possible. Others are less concerned with how quickly a wound heals, but they place high value on not leaving a scar.
Patients also require honesty from their medical staff. That means letting patients know if they have wounds that will not heal, or if the treatment will be worse than the wound itself. In those cases, they want to be involved in the decision on how to move forward.
Medical professionals know that wounds have many different elements and require different types of treatment. Patients' goals are even more varied. Letting the patient drive the direction of care can make a huge difference in the quality of life for the patient.
3. Communicate effectively
Patients desire information and empowerment.
They want to know what their options are with any course of treatment, and what types of treatments they might be eligible to receive.
Ultimately, they prioritize being involved in the planning stages of treatment, both so they can be more aware of what they might encounter along the way, and because they simply want to feel as independent as possible, even when they might be hampered by wounds that limit them dramatically.
Strong communication between the patients and the medical professional at all stages of treatment builds trust that will pay off repeatedly. It will also ease the burden on both. When a patient is involved in the decisions, he or she will not resist the treatment, even if it is challenging.
Meeting the Next Wave of Challenges
The future of wound care is full of promise thanks to major advances in technology. Each year brings more information in the war on pressure wounds and more ideas on how to prevent them and on how to fight them when they appear.
Meeting those challenges means keeping the patient at the core of all research and treatment. That means improving the ability to listen to patients needs, promoting their self-care and involvement in treatment, and focusing on their quality of life.
This course, in essence, the only way to navigate the challenges while keeping within an already strained budget on wound care.